Haertling, Braedon

Haertling, Braedon is an individual health care provider with primary practice located at 4121 Veterans Memorial Dr , Mount Vernon IL 62864-6262. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Haertling, Braedon can be contacted via phone (618) 214-8392.

Contact Information

Primary practice address
4121 Veterans Memorial Dr Mount Vernon IL 62864-6262
Phone: (618) 214-8392
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085007253 Illinois

Profile Details

NPI number 1689223729
LBN Legal business name Haertling, Braedon
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2019
Last updated Sep 11th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689223729 NPPES
Illinois Other 085007253 PHYSICIAN ASSISTANT LICENSE

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